Active NPI
Kelsi McCoy-Wilson, MD
- Pediatrics Physician
- Los Angeles, CA
National Provider Identifier
1730574856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A146786
- Practice address
- 757 Westwood PLZ
B711 Rrumc
Los Angeles, CA 90095-7419 - Phone
- (310) 267-9129
- NPI assigned
- Apr 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A146786 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
757 Westwood PLZ
B711 Rrumc
Los Angeles, CA 90095-7419
Mailing address
14445 Olive View Dr # S
Sylmar, CA 91342-1437
Phone (747) 210-3233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230912003326 | CA | Order and Referring Only - Pediatric Medicine | 2062767155 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A146786 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1730574856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14445 OLIVE VIEW DR # S",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913421437",
"telephone_number": "747-210-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ",
"address_2": "B711 RRUMC",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900957419",
"telephone_number": "310-267-9129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY-WILSON",
"first_name": "KELSI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A146786",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.